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Clinical outcomes of the surgical treatment of isolated unilateral facet fractures, subluxations, and dislocations in the pediatric cervical spine: report of eight cases and review of the literature

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Abstract

Purpose

We present a small series consisting of eight children with unilateral facet injury of the cervical spine treated surgically.

Methods

A retrospective review was performed. Injury data, radiographs, surgical data, and outcomes (Neck Disability Index (NDI), Short Form 36 (SF-36), and Visual Analog Scale for Neck Pain (VAS-NP)) were collected from seven patients. A literature review was performed for one additional case.

Results

Motor vehicle accidents (62 %, n = 5) and falls (38 %, n = 3) accounted for all injuries. The C6–7 level accounted for most of the injuries (37.5 %, n = 3). The mean NDI score with at least 3 months follow-up was 5.3 (n = 6, range, 1–12; standard deviation, 4.5), corresponding to mild disability. Of the norm-based SF-36 scale scores available (n = 6), the mean physical functioning (PF), role-physical (RP), and role-emotional (RE) scores were significantly less than the adult, age 18–24, norm-based means, with a mean difference of −6.4, −9.13, and −11.3, respectively (p value = 0.03, 0.001, and 0.01, respectively). The mean general health (GH) and vitality (VT) scores, however, were significantly greater than the adult, age 18–24, norm-based mean, with a mean difference of 7.82 and 10.3 (p = 0.04 and 0.02, respectively). VAS-NP showed a return to the “no pain” level at 3 months or more follow-up in all patients.

Conclusions

We suggest that surgical treatment of these injuries in the pediatric age group may lead to satisfactory clinical and radiographic outcomes, but HRQoL analysis suggests that patients remain physically and emotionally disabled to some degree after surgery.

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Authors and Affiliations

  1. Neuro-Spine Program, Division of Pediatric Neurosurgery, Department of Neurosurgery, Baylor College of Medicine, Texas Children’s Hospital, 6621 Fannin Street, CCC 1230.01, 12th Floor, Houston, TX, 77030, USA

    Jonathan N. Sellin, Sheila L. Ryan, Alison Brayton & Andrew Jea

  2. Division of Pediatric Neurosurgery, Riley Children’s Hospital, Department of Neurosurgery, Indiana University, Indianapolis, IN, USA

    Kashif Shaikh & Daniel H. Fulkerson

Authors
  1. Jonathan N. Sellin
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  2. Kashif Shaikh
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  3. Sheila L. Ryan
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  6. Andrew Jea
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Correspondence to Andrew Jea.

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Sellin, J.N., Shaikh, K., Ryan, S.L. et al. Clinical outcomes of the surgical treatment of isolated unilateral facet fractures, subluxations, and dislocations in the pediatric cervical spine: report of eight cases and review of the literature. Childs Nerv Syst 30, 1233–1242 (2014). https://doi.org/10.1007/s00381-014-2395-6

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  • DOI: https://doi.org/10.1007/s00381-014-2395-6

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